玉液汤联合氯沙坦治疗早期糖尿病肾病的临床研究  

Yuye Tang combined with losartan in the treatment of Type 2 diabetic nephropathy:A clinical study

作　　者：常快乐[1] 郑龙[1] 高永利[1] CHANG Kuai-le;ZHENG Long;GAO Yong-li(Department of Cardiology and Nephrology,the 3rd Hospital of PLA,Baoji,Shaanxi 721004,China)

机构地区：[1]解放军第三医院心肾内科,陕西宝鸡721004

出　　处：《实用医药杂志》2019年第5期398-401,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的研究玉液汤联合氯沙坦对2型糖尿病肾病患者肾功能以及血浆脂联素(adiponectin,APN)和脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LP-PLA2)的影响。方法选择笔者所在医院心肾内科住院的2型糖尿病肾病患者126例(均符合早期糖尿病肾病的诊断标准),随机分为2组:治疗组及对照组各63例,对照组给予氯沙坦治疗1个月,治疗组在氯沙坦治疗基础上服用玉液汤1剂/d,水煎服,2次/d,检测和比较治疗前后两组患者肌酐(Cr)、尿素氮(BUN)、胱抑素C(CysC)、尿酸(UA)、β2-微球蛋白(β2-MG)和24 h尿蛋白定量(24h-UPE)以及血浆LP-PLA2和APN水平。结果治疗后两组患者的Cr、CysC、UA、β2-MG、24h-UPE和LPPLA2水平较治疗前明显降低;血浆APN水平较治疗前明显升高,前后比较差异有统计学意义(P<0.05)。治疗组患者血浆Cr、CysC、UA、β2-MG、24h-UPE水平和LP-PLA2水平较对照组明显降低,血浆APN水平明显升高,组间差异均有统计学意义(P<0.05)。结论玉液汤联合氯沙坦治疗可更好地保护早期糖尿病肾病患者的肾功能,这可能与其提高血浆APN水平和降低LP-PLA2水平,改善血管内皮功能有关。Objective To investigate the effect of Yuye Tang(a TCM formula,shortly named as Tang) combined with losartan on renal function and serum adiponectin(APN) and lipoprotein-associated phospholipase A2(LP-PLA2) levels in patients with type 2 diabetic nephropathy(DN). Methods The 126 DN patients in author's hospital were enrolled and randomly divided into treatment group and control group in this study,DN was defined as the presence of 24h-UPE and Scr. To control group were given losartan(50mg/d) for 1 month. To treatment group were given both losartan(50-100mg/d) and Tang(2/d) for 1 month. Blood and urine specimen were obtained at the baseline and 1 month later. The plasma concentrations of APN were determined by using ELISAs. Urine 24h-UPE and Blood Cr,CysC,UA,β2-MG and LP-PLA2 were detected routinely. The obtained data were compared before and after treatment. Results The Cr,CysC,UA,β2-MG,LP-PLA2 and 24h-UPE level were significantly decreased after 1 month of treatment compared with those before treatment(P<0.05). The Cr,CysC,UA,β2-MG,LP-PLA2 and 24h-UPE of treatment group were significantly decreased compared with those of control group after 1 month of treatment(P<0.05). The serum APN level was increased after 1 month of treatment compared with before(P<0.05). The serum APN of treatment group was significantly increased compared with control group after 1 month of treatment(P<0.05). Conclusion Tang combined with losartan could better protect renal function in patients with early DN,and increase level of plasma APN,as well decreased level of LP-PLA2,which may be related with improved vascular endothelial function.

关 键 词：玉液汤 氯沙坦 糖尿病肾病 血管内皮功能 脂联素 脂蛋白相关磷脂酶A2 

分 类 号：R587.2[医药卫生—内分泌]